| NPI | 1427314731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA 5281) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY P71053) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3673) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2022-08-16 |