NPI | 1831181536 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO 597) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: CO CO597) |
Enumeration Date | 2005-08-18 |
Last Update Date | 2019-10-29 |