NPI | 1700286846 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 224P00000X Prosthetist (Licence: CA C50076) |
Additional Taxonomies | 222Z00000X Orthotist (Licence: CA C50076) |
Enumeration Date | 2014-08-26 |
Last Update Date | 2014-08-26 |