| NPI | 1871987313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Additional Taxonomies | 2472E0500X Technician, Other, EEG |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-08-13 |