NPI | 1073078085 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016.005918) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: GA POD001404) |
213E00000X Podiatrist (Licence: IN 07001343A) | |
Enumeration Date | 2019-02-04 |
Last Update Date | 2023-12-04 |