NPI | 1255570495 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: LA DPM.200030) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO 3359) |
Enumeration Date | 2009-02-11 |
Last Update Date | 2013-06-13 |