NPI | 1437128295 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC001504L) |
Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: PA SC001504L) |
213ER0200X Podiatrist, Radiology (Licence: PA SC001504L) | |
213ES0000X Podiatrist, Sports Medicine (Licence: PA SC001504L) | |
Enumeration Date | 2006-03-15 |
Last Update Date | 2016-10-20 |