FS (192.168.0.4) -> NAT (Public IP 1.2.3.4) -> INTERNET -> NAT (Public IP 5.6.7.8) -> PHONE (192.168.1.100)

I followed the instructions from http://wiki.freeswitch.org/wiki/General_NAT_example_scenarios and have created the profile like:

<!-- http://wiki.freeswitch.org/wiki/Sofia_Configuration_Files -->
<profile name="external">
  <!-- This profile is only for outbound registrations to providers -->
  <gateways>
    <X-PRE-PROCESS cmd="include" data="external/*.xml"/>
  </gateways>

  <aliases>
    <alias name="outbound"/>
  </aliases>

  <domains>
    <domain name="$${domain}" parse="true"/>
  </domains>

  <settings>
    <param name="debug" value="0"/>
    <param name="force-register-domain" value="$${domain}"/>
    <param name="apply-nat-acl" value="rfc1918"/>
    <param name="sip-trace" value="no"/>
    <param name="rfc2833-pt" value="101"/>
    <param name="sip-port" value="5090"/>
    <param name="dialplan" value="XML"/>
    <param name="context" value="public"/>
    <param name="dtmf-duration" value="100"/>
    <param name="codec-prefs" value="$${outbound_codec_prefs}"/>
    <param name="hold-music" value="$${hold_music}"/>
    <param name="use-rtp-timer" value="true"/>
    <param name="rtp-timer-name" value="soft"/>
    <param name="manage-presence" value="false"/>
    <param name="aggressive-nat-detection" value="true"/>
    <param name="inbound-codec-negotiation" value="generous"/>
    <param name="nonce-ttl" value="60"/>
    <param name="auth-calls" value="false"/>
    <param name="rtp-timeout-sec" value="1800"/>
    <param name="rtp-ip" value="$${local_ip_v4}"/>
    <param name="sip-ip" value="$${local_ip_v4}"/>
    <param name="ext-rtp-ip" value="$${external_rtp_ip}"/>
    <param name="ext-sip-ip" value="$${external_sip_ip}"/>
    <param name="rtp-timeout-sec" value="300"/>
    <param name="rtp-hold-timeout-sec" value="1800"/>
  </settings>
</profile>

In the phone I am using  the {external IP} :5090.  I went to the router and forwarded the 5090 to the machine where FS is running.

The phone register and I can call internal extensions but I cannot place calls to PSTN (Call Failed)

The profile is invalid.

  sofia status profile doublenat
API CALL [sofia(status profile doublenat)] output:
Invalid Profile!