NPI | 1033155163 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CT 000806) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: CT 000806) |
213ER0200X Podiatrist, Radiology (Licence: CT 000806) | |
213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: CT 000806) | |
Enumeration Date | 2006-06-20 |
Last Update Date | 2008-07-30 |