| NPI | 1629038849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO POD.0000737) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07000972A) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2023-06-20 |