| NPI | 1417401944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AL 387) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA EL6682) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: AL 387) | |
| Enumeration Date | 2016-08-13 |
| Last Update Date | 2024-02-15 |