| NPI | 1942450895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CO POD-688) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IL 016.005382) |
| Enumeration Date | 2008-09-29 |
| Last Update Date | 2024-10-29 |