| NPI | 1700343183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225C00000X Rehabilitation Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic | |
| 247200000X Technician, Other | |
| 2472E0500X Technician, Other, EEG | |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2019-02-21 |