| NPI | 1326406463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Z00000X (Licence: CA C50283) |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management (Licence: CA C50283) |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2016-07-26 |