NPI | 1316027386 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: VT 056-0000137) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: NH 0238) |
Enumeration Date | 2006-10-16 |
Last Update Date | 2007-07-08 |