| NPI | 1497947733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: SC 699) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3310) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: LA DPM.200020) | |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2019-12-17 |