NPI | 1992020432 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: ID P-282) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: MO 2008027655) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WY 141) | |
Enumeration Date | 2010-03-27 |
Last Update Date | 2023-09-27 |