| NPI | 1740517523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: HI PO-198) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NH 0339) |
| Enumeration Date | 2009-11-16 |
| Last Update Date | 2021-06-02 |