NPI | 1720473820 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD305040) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: TN 860) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TN 860) | |
Enumeration Date | 2015-04-06 |
Last Update Date | 2024-11-05 |