| NPI | 1891152336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: TX 877) |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: NV 277) |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2016-01-27 |