NPI | 1629392568 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E4881) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4881) |
213ES0131X Podiatrist, Foot Surgery (Licence: CA E4881) | |
Enumeration Date | 2010-03-22 |
Last Update Date | 2014-06-10 |