| NPI | 1992748115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: MD Cp02959) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA CP) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2018-09-06 |