NPI | 1841630225 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006899) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO POD.0000776) |
Enumeration Date | 2013-06-28 |
Last Update Date | 2022-01-04 |