NPI | 1336238336 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: NC 154) |
Additional Taxonomies | 213EP0504X Podiatrist, Public Medicine (Licence: NC 154) |
213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NC 154) | |
213ER0200X Podiatrist, Radiology (Licence: NC 154) | |
213ES0000X Podiatrist, Sports Medicine (Licence: NC 154) | |
213ES0131X Podiatrist, Foot Surgery (Licence: NC 154) | |
Enumeration Date | 2006-10-11 |
Last Update Date | 2016-04-04 |