NPI | 1609800390 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016004568) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: TN 0000000498) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2007-07-08 |