| NPI | 1154480887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WV 10442) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E5423) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO4022) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36.003534) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC005582) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2023-03-07 |