NPI | 1073049458 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT 12160807-0501) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO PDT.0000563) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM POD432) | |
390200000X Student in an Organized Health Care Education/Training Program (Licence: CO PDT.0000563) | |
Enumeration Date | 2017-05-04 |
Last Update Date | 2023-03-29 |