| NPI | 1437266145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: VA 0103300961) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: DC PO1000050) |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MD 01438) | |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CA E4544) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2022-07-21 |