NPI | 1194704023 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: MD 01135) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: DC PO499) |
Enumeration Date | 2006-01-10 |
Last Update Date | 2023-01-27 |