NPI | 1760572234 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: MA 1930) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MA 1930) |
Enumeration Date | 2006-10-13 |
Last Update Date | 2009-04-07 |