NPI | 1932409505 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 222Z00000X Orthotist (Licence: SC C26262) |
Additional Taxonomies | 224P00000X Prosthetist (Licence: SC C26262) |
Enumeration Date | 2010-10-28 |
Last Update Date | 2016-11-08 |