| NPI | 1316798804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZX2200X Specialist/Technologist, Other, Orthopedic Assistant |
| Additional Taxonomies | 374U00000X Home Health Aide |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |