| NPI | 1164749669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AZ POD-001027) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WA PO60277402) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NV 1007) | |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2024-04-19 |