NPI | 1629363072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AZ 041394) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: KY 041394) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07001258A) | |
Enumeration Date | 2011-06-14 |
Last Update Date | 2024-04-29 |