| NPI | 1972814358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006229) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR DP164562) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WA PO60402238) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2014-09-29 |