NPI | 1932253689 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: DE E10000193) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC005870) |
Enumeration Date | 2007-01-22 |
Last Update Date | 2018-09-06 |