| NPI | 1508885484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0500X Specialist/Technologist, Other, EEG |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-01-19 |