| NPI | 1043472269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TN 703) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TN 703) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC005923) | |
| Enumeration Date | 2008-06-29 |
| Last Update Date | 2024-02-09 |