NPI | 1033746649 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC007354) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC007354) |
Enumeration Date | 2020-03-24 |
Last Update Date | 2024-01-18 |