| NPI | 1538652839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NH 0379) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VT 061.0000025) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2022-01-18 |