NPI | 1134553787 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: VA 0103-301097) |
Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: VA 0103-301097) |
Enumeration Date | 2013-08-29 |
Last Update Date | 2013-08-29 |