NPI | 1275586919 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CA E2781) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E2781) |
Enumeration Date | 2006-05-17 |
Last Update Date | 2024-09-25 |