NPI | 1588955231 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NC 617) |
Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NC 617) |
213ES0131X Podiatrist, Foot Surgery (Licence: NC 617) | |
Enumeration Date | 2011-04-29 |
Last Update Date | 2022-08-09 |