| NPI | 1447024468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 171W00000X Contractor |
| 1744P3200X Specialist, Prosthetics Case Management | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2025-10-10 |