NPI | 1255466348 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 222Z00000X Orthotist (Licence: NC CO003055) |
Additional Taxonomies | 224L00000X Pedorthist (Licence: CPED0755) |
225000000X Orthotic Fitter | |
Enumeration Date | 2007-02-22 |
Last Update Date | 2022-04-05 |