NPI | 1598087413 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 2011025326) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: MO 2011025326) |
Enumeration Date | 2010-02-18 |
Last Update Date | 2022-09-12 |