| NPI | 1598391799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZE0500X Specialist/Technologist, Other, EEG |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2020-03-19 |