| NPI | 1013163104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224P00000X Prosthetist (Licence: FL POR15) |
| Additional Taxonomies | 222Z00000X Orthotist (Licence: FL POR15) |
| 225000000X Orthotic Fitter (Licence: FL POR15) | |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2008-08-08 |