NPI | 1801246186 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: LA 311931) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: IA 082181) |
Enumeration Date | 2016-06-16 |
Last Update Date | 2019-08-07 |