| NPI | 1598437899 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: FL CL290859) |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management |
| 224P00000X Prosthetist | |
| 224P00000X Prosthetist (Licence: FL CL290859) | |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2023-03-02 |