NPI | 1962472688 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO2616) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: FL PO2616) |
Enumeration Date | 2006-01-25 |
Last Update Date | 2024-12-23 |