| NPI | 1548242647 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CT 040098) |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other Electroneurodiagnostic (Licence: CT 040098) |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2024-01-24 |