NPI | 1518380872 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO POD.0000813) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR DP174057) |
Enumeration Date | 2014-01-22 |
Last Update Date | 2018-03-21 |