NPI | 1538279955 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2006-08-30 |
Last Update Date | 2007-12-19 |