| NPI | 1710988233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: OK 222) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: LA PD307R) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2022-06-15 |