NPI | 1023758497 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY N007417) |
Enumeration Date | 2022-03-31 |
Last Update Date | 2025-04-01 |