NPI | 1326602004 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CT 1132) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: DE E1-0010285) |
Enumeration Date | 2019-04-28 |
Last Update Date | 2025-02-12 |