| NPI | 1427541937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: OH 36.004092) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MI 5951000961) |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MI 5901002729) | |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: FL PO4261) | |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2023-08-21 |