NPI | 1174018287 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CA 5884) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-06-30 |
Last Update Date | 2023-03-15 |