| NPI | 1952535122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Additional Taxonomies | 2472E0500X |
| 246ZE0500X Specialist/Technologist, Other, EEG | |
| 225700000X Massage Therapist | |
| Enumeration Date | 2009-05-04 |
| Last Update Date | 2012-04-04 |