| NPI | 1881887263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NE 352) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016.005498) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MN 834) | |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2022-03-21 |