NPI | 1487649000 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36.003706) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: IN 07000948A) |
Enumeration Date | 2005-09-20 |
Last Update Date | 2023-11-08 |