NPI | 1366440406 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: PA SC002781L) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC002781L) |
Enumeration Date | 2005-07-12 |
Last Update Date | 2022-07-01 |