| NPI | 1013246701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MO 2011014616) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery (Licence: MO 2011014616) |
| 213E00000X Podiatrist (Licence: MO 2011014616) | |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2024-07-08 |