| NPI | 1699797910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: KS 12-00203) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: KS 12-00203) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-15 |