NPI | 1265759120 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 222Z00000X Orthotist (Licence: WA OI00000090) |
Additional Taxonomies | 224P00000X Prosthetist (Licence: WA PS00000089) |
Enumeration Date | 2010-04-30 |
Last Update Date | 2010-05-03 |