| NPI | 1033271705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E1387) |
| Additional Taxonomies | 213ES0000X Podiatrist, Sports Medicine (Licence: CA E1387) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: CA E1387) | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2010-07-12 |