NPI | 1891739991 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: VA 0103 000583) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: NC 219) |
Enumeration Date | 2006-06-16 |
Last Update Date | 2013-03-29 |