| NPI | 1982038923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246Z00000X Specialist/Technologist, Other (Licence: 2106) |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: 498) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2013-08-27 |