| NPI | 1275988933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: TX 2385) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 2385) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2024-11-04 |