| NPI | 1699272724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OR DP202065) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA 000000) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: PA SC006916) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR DP202065) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006916) | |
| 213ES0131X (Licence: OR DP202065) | |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2021-09-30 |