NPI | 1588628853 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: MA 2199) |
Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: MA 2199) |
Enumeration Date | 2006-04-13 |
Last Update Date | 2011-08-31 |