| NPI | 1114156726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CO POD.0000886) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MI 5901002330) |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: WA OP60294170) | |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2023-05-09 |