| NPI | 1366686800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO 710) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM 348) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36.003558) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT 5063880-0501) | |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2021-09-10 |