| NPI | 1245647247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: TX 2242) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: NY P89395) |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2022-07-21 |