NPI | 1528326725 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: FL PO3729) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: FL PO3729) |
Enumeration Date | 2012-04-25 |
Last Update Date | 2023-08-21 |