| NPI | 1760054456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224P00000X Prosthetist |
| Additional Taxonomies | 1744P3200X Specialist Prosthetics Case Management |
| 1744P3200X Specialist Prosthetics Case Management (Licence: OH 1760054456) | |
| 224P00000X Prosthetist (Licence: OH 1760054456) | |
| 1744P3200X Specialist Prosthetics Case Management | |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2021-08-02 |