NPI | 1033774237 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: NY N007225) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N007225) |
213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NY N007225) | |
213ER0200X Podiatrist, Radiology (Licence: NY N007225) | |
213ES0000X Podiatrist, Sports Medicine (Licence: NY N007225) | |
Enumeration Date | 2019-05-03 |
Last Update Date | 2023-10-09 |