NPI | 1083235253 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM POD22006) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC007104) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-04-29 |
Last Update Date | 2023-05-19 |