| NPI | 1447473962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: KS 12-00368) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WA PO00000787) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 2008003822) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2019-12-16 |