NPI | 1295766475 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0000X Podiatrist, Sports Medicine (Licence: CA E4222) |
Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: CA E4222) |
Enumeration Date | 2006-07-05 |
Last Update Date | 2024-07-23 |