NPI | 1093712184 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: DC PO423) |
Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: MD 00926) |
Enumeration Date | 2005-07-05 |
Last Update Date | 2010-12-03 |