| NPI | 1689803348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OK 293) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006107) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36003638) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2013-07-01 |