NPI | 1174576433 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: TN DPM635) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: TN DPM635) |
Enumeration Date | 2006-05-18 |
Last Update Date | 2022-03-16 |