NPI | 1174541726 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E1442) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E1442) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2008-06-20 |