| NPI | 1427344563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR DP177024) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WA PL60221075) |
| 213ES0131X (Licence: AZ 0808) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2025-08-22 |