NPI | 1205894391 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO-3185) |
Additional Taxonomies | 208D00000X General Practice (Licence: FL PO3185) |
Enumeration Date | 2006-05-01 |
Last Update Date | 2022-03-14 |