NPI | 1578533667 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36.003654) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC003270L) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NC 567) | |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC003270L) | |
213ES0131X Podiatrist, Foot Surgery (Licence: PA SC003270L) | |
Enumeration Date | 2006-01-23 |
Last Update Date | 2022-01-05 |