| NPI | 1154383891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0103000820) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WV 258) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: VA 0103000820) | |
| 213ES0131X Podiatrist, Foot Surgery (Licence: WV 258) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2023-12-12 |