NPI | 1912994211 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: MA 1539) |
Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: MA 1539) |
Enumeration Date | 2005-10-02 |
Last Update Date | 2014-01-15 |