NPI | 1134148307 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IA 097112) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MN 016005204) |
Enumeration Date | 2006-07-19 |
Last Update Date | 2020-02-12 |