| NPI | 1982654042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0101053861) |
| Additional Taxonomies | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: VA 0101053861) |
| 2278P1004X Respiratory Therapist, Certified, Pulmonary Diagnostics (Licence: VA 0101053861) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2014-03-20 |