| NPI | 1992188437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 692090) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: KY 00435) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07001276A) | |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2024-09-13 |