| NPI | 1881278265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AZ POD-001116) |
| Additional Taxonomies | 211D00000X Assistant, Podiatric |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2024-07-05 |