NPI | 1225051519 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: KY 155) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: ME POD1501) |
Enumeration Date | 2006-07-26 |
Last Update Date | 2015-03-26 |