| NPI | 1215378021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: NONE) |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2013-07-09 |