| NPI | 1952669988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NH 0357) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NH 0357) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2021-09-23 |