NPI | 1942628813 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MD 01645) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0103301238) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 003798) | |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: DC PO1000149) | |
Enumeration Date | 2014-03-28 |
Last Update Date | 2022-07-21 |