NPI | 1447296843 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 2222) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: VA 0103300863) |
Enumeration Date | 2006-06-22 |
Last Update Date | 2023-01-31 |