NPI | 1265436141 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: KY 00305) |
Additional Taxonomies | 213EP0504X Podiatrist, Public Medicine (Licence: KY 244094) |
Enumeration Date | 2005-06-09 |
Last Update Date | 2024-09-23 |