| NPI | 1992402119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZE0500X Specialist/Technologist, Other, EEG (Licence: NJ 456) |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic (Licence: NJ 4926) |
| Enumeration Date | 2023-02-08 |
| Last Update Date | 2023-02-08 |