| NPI | 1568698074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AZ 0764) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: AZ 0764) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: AZ 0764) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0116021668) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36.003606) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2021-07-28 |