NPI | 1225034176 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO1182) |
Additional Taxonomies | 213ES0000X Podiatrist, Sports Medicine (Licence: FL PO1182) |
213ES0131X Podiatrist, Foot Surgery (Licence: FL PO1182) | |
Enumeration Date | 2005-06-24 |
Last Update Date | 2020-07-20 |