| NPI | 1841710381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E5668) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IN 41000363A) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2021-09-29 |