NPI | 1679599633 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: SD 200) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IA 783T) |
Enumeration Date | 2006-07-14 |
Last Update Date | 2022-05-17 |