NPI | 1861729782 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 224P00000X Prosthetist (Licence: CPO01732) |
Additional Taxonomies | 225000000X Orthotic Fitter (Licence: NC 1732) |
222Z00000X Orthotist (Licence: CPO01732) | |
224L00000X Pedorthist (Licence: CPed0326) | |
Enumeration Date | 2009-11-13 |
Last Update Date | 2012-03-06 |