NPI | 1710534821 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 224P00000X Prosthetist (Licence: CA C51502) |
Additional Taxonomies | 222Z00000X Orthotist (Licence: CA C51502) |
Enumeration Date | 2019-08-22 |
Last Update Date | 2019-08-22 |