| NPI | 1629464359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0500X Specialist/Technologist, Other, EEG |
| Additional Taxonomies | 247200000X Technician, Other |
| 2472E0500X Technician, Other, EEG | |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2015-04-09 |