| NPI | 1437186012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: GA POD001143) |
| Additional Taxonomies | 213ES0000X Podiatrist, Sports Medicine (Licence: OH 36003362) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: OH 36003362) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2024-01-17 |