| NPI | 1043606247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36.004061) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WI 111825) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07001318A) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016005776) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2024-04-17 |