| NPI | 1225154370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3821) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07001057A) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36003446) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2024-09-26 |