| NPI | 1891735445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4622) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: CA E4622) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2022-04-11 |