NPI | 1003392457 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: AZ POD-000908) |
Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: AZ POD-000908) |
213ER0200X Podiatrist, Radiology (Licence: AZ POD-000908) | |
213ES0000X Podiatrist, Sports Medicine (Licence: AZ POD-000908) | |
213ES0131X Podiatrist, Foot Surgery (Licence: AZ POD-000908) | |
Enumeration Date | 2018-07-18 |
Last Update Date | 2018-07-18 |