NPI | 1255768172 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 224P00000X Prosthetist (Licence: DE C22040) |
Additional Taxonomies | 222Z00000X Orthotist (Licence: DE C22040) |
Enumeration Date | 2013-10-09 |
Last Update Date | 2015-03-11 |