| NPI | 1083111207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD001519) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36.004003) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MA 1484) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC007153) | |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2022-10-06 |