| NPI | 1114920121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MA 1924) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: RI RIDPM265) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2023-11-08 |