| NPI | 1487949384 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AZ 000983) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OK 311) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5315051097) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2023-07-05 |