| NPI | 1962421479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224P00000X Prosthetist (Licence: RI CP00016) |
| Additional Taxonomies | 1744P3200X Specialist, Prosthetics Case Management (Licence: RI CP00016) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2020-03-02 |