NPI | 1477087112 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NC 763) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: NC 763) |
Enumeration Date | 2017-04-19 |
Last Update Date | 2025-06-06 |