NPI | 1508885872 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: FL PO3147) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: FL PO3147) |
Enumeration Date | 2006-07-18 |
Last Update Date | 2014-10-22 |