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Individual
NRUP TOLAT
Active
Individual
NRUP TOLAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
POD001368
GA
213ES0000X
Sports Medicine Podiatrist
POD001368
GA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001368
GA
Other
Enumeration date
06/10/2015
Last updated
09/23/2020
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