| NPI | 1023325024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 2056) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 2056) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX T34-2010) | |
| Enumeration Date | 2010-09-12 |
| Last Update Date | 2023-11-15 |