| NPI | 1144756677 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA 5976) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA 5976) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3948) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT 11694035-0501) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA E5976) | |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2024-05-03 |