NPI | 1891794715 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: OK 178) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: OK 178) |
Enumeration Date | 2005-07-21 |
Last Update Date | 2012-03-28 |