NPI | 1992784631 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 1620) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 1620) |
Enumeration Date | 2006-01-11 |
Last Update Date | 2007-12-19 |