NPI | 1720055387 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: MI AM001831) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI AM001831) |
Enumeration Date | 2006-03-02 |
Last Update Date | 2008-02-26 |