NPI | 1558470740 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 224P00000X Prosthetist |
Additional Taxonomies | 222Z00000X Orthotist |
335E00000X Prosthetic/Orthotic Supplier | |
Enumeration Date | 2006-08-30 |
Last Update Date | 2020-09-10 |