| NPI | 1184501991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224P00000X Prosthetist (Licence: TN PR00000000014) |
| Additional Taxonomies | 222Z00000X (Licence: TN ORT0000000013) |
| Enumeration Date | 2025-08-21 |
| Last Update Date | 2025-08-21 |