NPI | 1285052712 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E5300) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA 6704) |
Enumeration Date | 2014-04-02 |
Last Update Date | 2023-01-25 |