| NPI | 1659616431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other Electroneurodiagnostic (Licence: CO 1049) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: CO 1049) |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2023-05-18 |