| NPI | 1285186379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ELLERBE Certified Hair Loss Specialist 518-209-0817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier (Licence: NY aec14009444) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-10-25 |