| NPI | 1275712390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0000X Podiatrist, Sports Medicine (Licence: NH 0378) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NH 0378) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VT 0560000181) | |
| 213ES0131X Podiatrist, Foot Surgery (Licence: NH 0378) | |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2022-01-26 |