| NPI | 1952983710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 224P00000X Prosthetist (Licence: FL POR410) |
| Additional Taxonomies | 222Z00000X Orthotist (Licence: FL POR410) |
| 222Z00000X Orthotist (Licence: FL ORT337) | |
| Enumeration Date | 2021-04-22 |
| Last Update Date | 2022-04-11 |