NPI | 1922057173 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4339) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NV 0405) |
Enumeration Date | 2006-05-08 |
Last Update Date | 2022-12-06 |