| NPI | 1750301545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AZ 635) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GU Pod-2) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA e3868) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2013-07-29 |