| NPI | 1538797428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OK 399) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 59.000978) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2024-04-17 |