NPI | 1396794459 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 222Z00000X Orthotist (Licence: TX 604) |
Additional Taxonomies | 174400000X Specialist (Licence: TX 604) |
224P00000X Prosthetist (Licence: TX 604) | |
Enumeration Date | 2006-05-08 |
Last Update Date | 2024-09-18 |