| NPI | 1598103905 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: FL PO3803) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3803) |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2018-03-22 |