NPI | 1174938229 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E5383) |
Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: CA E5383) |
Enumeration Date | 2014-06-27 |
Last Update Date | 2023-06-13 |