| NPI | 1689085706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224L00000X Pedorthist (Licence: DE CPed4080) |
| Additional Taxonomies | 224L00000X Pedorthist (Licence: MD C51558) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2014-05-12 |