| NPI | 1710178207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AZ POD001019) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3346) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM POD420) | |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2023-06-23 |