NPI | 1083901367 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OK 310) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 057638) |
Enumeration Date | 2011-07-07 |
Last Update Date | 2018-10-25 |