NPI | 1346234457 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E3543) |
Additional Taxonomies | 213ES0000X Podiatrist, Sports Medicine (Licence: CA E3543) |
Enumeration Date | 2005-09-02 |
Last Update Date | 2009-12-17 |