| NPI | 1508862087 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: TX 546) |
| Additional Taxonomies | 246ZE0500X Specialist/Technologist, Other, EEG (Licence: TX 1445) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2011-10-11 |