NPI | 1710491766 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0103301317) |
Additional Taxonomies | 251300000X Local Education Agency (LEA) |
Enumeration Date | 2017-11-29 |
Last Update Date | 2023-05-03 |