NPI | 1295780872 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 07000906) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 07000906) |
Enumeration Date | 2006-05-23 |
Last Update Date | 2011-02-21 |