| NPI | 1942793708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR DP197850) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WA PO61157008) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: ID P-262) | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2023-03-05 |