| NPI | 1932138427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA 3498) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E3498) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: CA 3498) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2024-05-06 |