| NPI | 1982870721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR DP151010) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: OR dp151010) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2024-08-07 |