NPI | 1376683052 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4249) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E4249) |
213ES0000X Podiatrist, Sports Medicine (Licence: CA E4249) | |
213ES0131X Podiatrist, Foot Surgery (Licence: CA E4249) | |
Enumeration Date | 2007-02-08 |
Last Update Date | 2013-04-19 |