| NPI | 1558408740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225000000X Orthotic Fitter |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management (Licence: not applicable) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2007-10-25 |