| NPI | 1649835562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E6087) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX T49-2021) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 3160) | |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2024-11-06 |