NPI | 1306167762 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 2053) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 2053) |
Enumeration Date | 2010-06-18 |
Last Update Date | 2023-09-22 |