| NPI | 1972162923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NV 2113) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR DP213005) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM POD22003) | |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2024-08-13 |