NPI | 1740392208 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4689) |
Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: CA E4689) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2017-08-26 |