NPI | 1932453917 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 2151) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 59.000433) |
Enumeration Date | 2012-10-30 |
Last Update Date | 2015-06-19 |