| NPI | 1467033134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CO POD.0000939) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 41000438A) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO POD.0000939) | |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2024-04-20 |