| NPI | 1255324612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E1834) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E1834) |
| 213EP0504X Podiatrist, Public Medicine (Licence: CA e1834) | |
| 213ER0200X Podiatrist, Radiology (Licence: CA E1834) | |
| 213ES0000X Podiatrist, Sports Medicine (Licence: CA E1834) | |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2007-12-06 |