NPI | 1598386286 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 692142) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 692142) |
213ES0131X Podiatrist, Foot Surgery (Licence: TX 692142) | |
Enumeration Date | 2020-05-04 |
Last Update Date | 2024-07-10 |