NPI | 1407351828 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: LA 326820) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: LA 326820) |
Enumeration Date | 2018-03-27 |
Last Update Date | 2023-02-08 |