| NPI | 1053168047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management |
| 1744P3200X Specialist, Prosthetics Case Management | |
| 224P00000X Prosthetist | |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2024-05-06 |