NPI | 1649446220 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NV 0904) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0116018774) |
Enumeration Date | 2008-05-05 |
Last Update Date | 2018-10-09 |