NPI | 1184913287 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N006434) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: FL PO3965) |
Enumeration Date | 2011-03-30 |
Last Update Date | 2019-04-23 |