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Individual
IAN JEROME GONZALES
Active
Individual
IAN JEROME GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R. EEG T, CLTM, CNIM
Taxonomy
Speciality
Code
Description
License number
State
246ZE0500X
EEG Specialist/Technologist
Primary
456
NJ
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
4926
NJ
Other
Enumeration date
02/08/2023
Last updated
02/08/2023
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