NPI | 1538572243 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E5378) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: CA 6675) |
Enumeration Date | 2014-06-10 |
Last Update Date | 2023-10-26 |