| NPI | 1003081951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: MD C16152) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2013-02-19 |