| NPI | 1396130316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CO POD.0000915) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO4001) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY N006894-1) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00346700) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO POD.0000915) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2023-01-27 |