| NPI | 1003065368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management (Licence: TX 318) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2023-03-07 |