NPI | 1366630303 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 224P00000X Prosthetist (Licence: CA CPO02952) |
Additional Taxonomies | 224P00000X Prosthetist |
225000000X Orthotic Fitter (Licence: CA CP002624) | |
224P00000X Prosthetist | |
222Z00000X Orthotist | |
222Z00000X Orthotist (Licence: CA CPO02952) | |
Enumeration Date | 2007-10-03 |
Last Update Date | 2011-05-11 |