NPI | 1699883009 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IA 00666) |
Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NE 303) |
Enumeration Date | 2006-08-26 |
Last Update Date | 2024-04-01 |