| NPI | 1407089261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E5009) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E5009) |
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: CA E5009) | |
| 213ES0000X Podiatrist, Sports Medicine (Licence: CA E5009) | |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2020-09-02 |