NPI | 1821351263 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MA PDF2428) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MA 1280) |
Enumeration Date | 2012-06-20 |
Last Update Date | 2025-03-17 |