| NPI | 1417925462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A90948) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: CA A90948) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA A90948) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2021-08-27 |