NPI | 1023221082 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MA 2328) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: MA 2328) |
213EP0504X Podiatrist Public Medicine (Licence: MA 2328) | |
213EP1101X Podiatrist Primary Podiatric Medicine (Licence: MA 2328) | |
213ER0200X Podiatrist Radiology (Licence: MA 2328) | |
213ES0000X Podiatrist Sports Medicine (Licence: MA 2328) | |
213ES0131X Podiatrist Foot Surgery (Licence: MA 2328) | |
Enumeration Date | 2007-05-07 |
Last Update Date | 2012-10-05 |