NPI | 1790829992 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA FZ216Z) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E14010) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E14010) | |
Enumeration Date | 2007-02-19 |
Last Update Date | 2024-05-13 |