| NPI | 1689049967 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: TX 3693) |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: TX 1444) |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2019-09-04 |