NPI | 1033271705 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E1387) |
Additional Taxonomies | 213ES0000X Podiatrist, Sports Medicine (Licence: CA E1387) |
213ES0131X Podiatrist, Foot Surgery (Licence: CA E1387) | |
Enumeration Date | 2006-12-15 |
Last Update Date | 2010-07-12 |