NPI | 1043428634 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT 11633905-0501) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E 4727) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA el 1582) | |
Enumeration Date | 2007-05-18 |
Last Update Date | 2021-07-30 |