| NPI | 1770714842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: NC 1184) |
| Additional Taxonomies | 246ZE0500X Specialist/Technologist, Other, EEG |
| 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: NY 1184) | |
| 2472E0500X | |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2022-03-08 |