NPI | 1750486072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: PA SC002068L) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: FL PO 1213) |
Enumeration Date | 2006-09-13 |
Last Update Date | 2007-07-08 |