| NPI | 1720137698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224P00000X Prosthetist (Licence: ABC CP003203) |
| Additional Taxonomies | 224P00000X Prosthetist (Licence: BOC C16482) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-08 |