NPI | 1417316258 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: LA DPM.200071) |
Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: LA DPM.200071) |
213ES0000X Podiatrist, Sports Medicine (Licence: LA DPM.200071) | |
Enumeration Date | 2016-02-22 |
Last Update Date | 2016-02-22 |