| NPI | 1689844813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: DE CP003404) |
| Additional Taxonomies | 222Z00000X (Licence: CA C22146) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2022-02-28 |