NPI | 1366686800 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO 710) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM 348) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36.003558) | |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT 5063880-0501) | |
Enumeration Date | 2009-04-28 |
Last Update Date | 2021-09-10 |