NPI | 1952899437 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY 007183) |
Enumeration Date | 2018-04-30 |
Last Update Date | 2022-05-10 |