| NPI | 1740544386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IA 097156) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006373) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TN 775) | |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2023-07-17 |