NPI | 1649217712 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NC 488) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: NC 488) |
Enumeration Date | 2006-05-31 |
Last Update Date | 2008-03-11 |