NPI | 1669575668 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: MS 80232) |
Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: OH 36.002457) |
Enumeration Date | 2006-09-06 |
Last Update Date | 2018-08-20 |