NPI | 1619020427 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 224P00000X Prosthetist (Licence: AR OPP00120) |
Additional Taxonomies | 222Z00000X Orthotist (Licence: AR OPP00120) |
Enumeration Date | 2007-01-18 |
Last Update Date | 2009-01-21 |