NPI | 1588813315 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 224P00000X Prosthetist (Licence: CP003523) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 5335) |
Enumeration Date | 2008-09-17 |
Last Update Date | 2008-09-17 |