| NPI | 1356312813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: CA e3278) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA pa13406) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2023-12-27 |