NPI | 1750509691 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5901002174) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 5901002174) |
213ER0200X Podiatrist, Radiology (Licence: MI 5901002174) | |
213ES0000X Podiatrist, Sports Medicine (Licence: MI 5901002174) | |
Enumeration Date | 2007-04-24 |
Last Update Date | 2008-03-03 |