| NPI | 1396744959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TN 00000833) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA e4705) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD001177) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00242700) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY N005485) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2022-07-19 |