| NPI | 1134161979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: TN 631) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: FL PO2652) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2009-04-03 |