NPI | 1043375173 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: MI PT000663) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: MI PT0000663) |
Enumeration Date | 2006-12-27 |
Last Update Date | 2017-07-20 |