NPI | 1629072392 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E1702) |
Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: CA E1702) |
Enumeration Date | 2005-06-09 |
Last Update Date | 2014-08-27 |