| NPI | 1902444714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: 4184) |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2022-12-12 |