| NPI | 1992801310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OR DP161066) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WA P060323725) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E2779) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM 314) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2013-03-06 |