NPI | 1609163153 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: FL PO3671) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3671) |
Enumeration Date | 2011-07-06 |
Last Update Date | 2023-01-03 |