| NPI | 1447424965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AK MED D 6023) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WA PO 60017003) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2011-05-25 |