NPI | 1114238953 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 2357) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC006187) |
213E00000X Podiatrist (Licence: FL PO3607) | |
Enumeration Date | 2010-06-26 |
Last Update Date | 2025-05-01 |