NPI | 1437314812 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 2008026233) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0103300984) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016005384) | |
Enumeration Date | 2008-07-24 |
Last Update Date | 2010-05-11 |