NPI | 1659504801 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: DE E1-0000192) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: DE E1-0000192) |
213E00000X Podiatrist (Licence: PA SC0005926) | |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC0005926) | |
Enumeration Date | 2009-09-03 |
Last Update Date | 2023-11-28 |