| NPI | 1144742008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224P00000X Prosthetist (Licence: OH LPO.00220) |
| Additional Taxonomies | 222Z00000X Orthotist (Licence: OH LPO.00220) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2022-07-21 |