NPI | 1285653782 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: MA 2171) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: MA 2171) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2024-09-27 |