NPI | 1497868962 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016005020) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: WI 856-025) |
Enumeration Date | 2006-08-17 |
Last Update Date | 2015-08-12 |