NPI | 1346537859 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E5089) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E5089) |
213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: CA E5089) | |
213ES0000X Podiatrist, Sports Medicine (Licence: CA E5089) | |
213ES0131X Podiatrist, Foot Surgery (Licence: CA E5089) | |
Enumeration Date | 2011-07-05 |
Last Update Date | 2017-04-06 |