NPI | 1831208586 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: PR 093) |
Additional Taxonomies | 213ES0131X Podiatrist Foot Surgery (Licence: PR 093) |
213ES0131X Podiatrist Foot Surgery (Licence: NJ MD2500) | |
Enumeration Date | 2006-08-29 |
Last Update Date | 2024-03-12 |