NPI | 1316191166 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA 4947) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MA 1222) |
Enumeration Date | 2008-11-06 |
Last Update Date | 2016-05-21 |