| NPI | 1699419002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246Y00000X Spec/Tech, Health Info (Licence: OH 1133610) |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy (Licence: OH R9k4c3G9) |
| 246ZE0500X Specialist/Technologist, Other, EEG (Licence: OH 1133610) | |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2022-04-22 |