NPI | 1992188452 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0103301240) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX t67-2015) |
Enumeration Date | 2015-07-01 |
Last Update Date | 2018-09-11 |