NPI | 1245253491 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: DE E1-0000262) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC005970) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: DE E1-0000262) | |
Enumeration Date | 2006-07-26 |
Last Update Date | 2021-03-03 |