NPI | 1417946591 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NH 0333) |
Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: MI 5901001395) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM 0328) | |
Enumeration Date | 2005-10-20 |
Last Update Date | 2014-05-02 |