| NPI | 1871529826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225000000X Orthotic Fitter (Licence: FL ORF 168) |
| Additional Taxonomies | 225000000X Orthotic Fitter (Licence: FL OFA 160) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2008-09-11 |