Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224P00000X | Prosthetist |
NPI | 1225653330 |
---|---|
Provider Name | Eduardo Arias |
First Address | Chicago, IL 60612-4353 |
Second Address | Chicago, IL 60612-4353 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2020 |
Last Update Date | 15/06/2020 |