NPI | 1871660050 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 222Z00000X Orthotist (Licence: DE RFOM0053) |
Additional Taxonomies | 224P00000X Prosthetist (Licence: DE RFOM0053) |
225000000X Orthotic Fitter (Licence: DE RFOM0053) | |
Enumeration Date | 2006-11-30 |
Last Update Date | 2007-07-08 |