| NPI | 1437442290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: ID P-240) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07001189B) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E5142) | |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2021-03-01 |