| NPI | 1841241742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NH 0233) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NH 233) |
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NH 233) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NH 0233) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2019-02-13 |