| NPI | 1548271828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA 3428) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA 00E3428) |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2025-01-21 |