NPI | 1104342781 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AZ POD-000975) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: AZ POD-000975) |
Enumeration Date | 2017-08-16 |
Last Update Date | 2023-02-06 |