NPI | 1831572296 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TN DPM000000835) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: TN DPM000000835) |
Enumeration Date | 2015-07-02 |
Last Update Date | 2023-06-09 |