| NPI | 1336594969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: DE E1-0010267) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: DE E1-0010267) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2023-10-12 |