NPI | 1760749626 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 213E00000X Podiatrist (Licence: WI 1054) |
Enumeration Date | 2012-04-17 |
Last Update Date | 2014-10-21 |