| NPI | 1467447169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD001209) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07001087A) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36003364M) | |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2022-01-07 |