| NPI | 1235543166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E5342) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 41000313a) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2017-11-06 |