| NPI | 1598033029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: GA POD001245) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: GA POD001245) |
| 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: GA POD001245) | |
| 213ES0131X Podiatrist Foot Surgery (Licence: GA POD001245) | |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2019-09-26 |