NPI | 1740213024 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: DE E10000085) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC004005L) |
Enumeration Date | 2006-07-09 |
Last Update Date | 2014-09-11 |