| NPI | 1598185712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: OR DP196169) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: OR 196169) |
| Enumeration Date | 2014-04-27 |
| Last Update Date | 2021-08-18 |