NPI | 1316492291 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 222Z00000X Orthotist (Licence: PA OH000284) |
Additional Taxonomies | 224L00000X Pedorthist (Licence: PA PD000109) |
Enumeration Date | 2016-08-19 |
Last Update Date | 2016-08-19 |