| NPI | 1629363072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AZ 041394) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: KY 041394) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07001258A) | |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2024-04-29 |