NPI | 1881019313 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: NC 672) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY 006797) |
Enumeration Date | 2014-02-20 |
Last Update Date | 2017-01-31 |