NPI | 1821784299 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 224L00000X Pedorthist (Licence: OH CPED1306) |
Additional Taxonomies | 222Z00000X Orthotist (Licence: OH C22312) |
222Z00000X Orthotist (Licence: OH LO.00382) | |
Enumeration Date | 2023-04-17 |
Last Update Date | 2023-05-11 |