| NPI | 1407820418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT 135349530501) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WA PO00000693) |
| 213E00000X Podiatrist (Licence: WA PO00000693) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NV 02101) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2024-12-12 |