| NPI | 1578188256 |
|---|---|
| Other Name | JAKE IRVING GREEN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR DP219527) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E5897) |
| 213E00000X Podiatrist (Licence: CA EL6961) | |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2024-05-08 |