| NPI | 1578033254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZE0500X Specialist/Technologist, Other, EEG (Licence: 4499) |
| Additional Taxonomies | 273100000X Epilepsy Unit (Licence: 138) |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: 878) | |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic (Licence: 16863) | |
| Enumeration Date | 2018-11-26 |
| Last Update Date | 2018-11-26 |