NPI | 1588667265 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NC 114) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: NC 114) |
Enumeration Date | 2005-05-24 |
Last Update Date | 2020-03-02 |