NPI | 1558352971 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4008) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM 260) |
Enumeration Date | 2005-11-03 |
Last Update Date | 2007-07-09 |