NPI | 1588663488 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N002755-1) |
Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NY N002755-1) |
213ES0000X Podiatrist, Sports Medicine (Licence: NY N002755-1) | |
213ES0131X Podiatrist, Foot Surgery (Licence: NY N002755-1) | |
Enumeration Date | 2005-07-21 |
Last Update Date | 2007-07-09 |