NPI | 1437635398 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: TX 3085) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC006946) |
Enumeration Date | 2018-07-13 |
Last Update Date | 2025-03-05 |