| NPI | 1710442447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Additional Taxonomies | 225500000X Specialist/Technologist |
| Enumeration Date | 2019-02-06 |
| Last Update Date | 2019-02-06 |