NPI | 1518167840 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: DC PO347) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: VA 0103000432) |
Enumeration Date | 2007-07-24 |
Last Update Date | 2007-08-28 |