NPI | 1265420673 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0131X Podiatrist Foot Surgery (Licence: AL 94) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: AL 94) |
Enumeration Date | 2005-10-10 |
Last Update Date | 2013-02-28 |