| NPI | 1518151661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Additional Taxonomies | 2472E0500X Technician, Other, EEG |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2018-04-27 |