| NPI | 1134326283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR DP180571) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WA PO 60158600) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2026-01-02 |