NPI | 1407892086 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: MA 1556) |
Additional Taxonomies | 213ES0000X Podiatrist, Sports Medicine (Licence: MA 1556) |
Enumeration Date | 2006-06-21 |
Last Update Date | 2007-07-08 |