| NPI | 1346491750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224P00000X Prosthetist (Licence: OK 61) |
| Additional Taxonomies | 222Z00000X Orthotist (Licence: OK 61) |
| 1744P3200X Specialist, Prosthetics Case Management (Licence: OK 61) | |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2008-10-03 |