NPI | 1386609204 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MO 0000481) |
Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IL 016003754) |
Enumeration Date | 2006-04-20 |
Last Update Date | 2011-02-03 |