NPI | 1659443935 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: TX 1394) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: UT 963253170501) |
Enumeration Date | 2006-11-14 |
Last Update Date | 2007-07-08 |