NPI | 1396874061 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E2026) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E2026) |
213ES0000X Podiatrist, Sports Medicine (Licence: CA E2026) | |
213ES0131X Podiatrist, Foot Surgery (Licence: CA E2026) | |
Enumeration Date | 2007-03-05 |
Last Update Date | 2010-07-19 |