NPI | 1487625299 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0000954) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MD 01243) |
Enumeration Date | 2006-01-30 |
Last Update Date | 2023-12-06 |