| NPI | 1003875915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00213300) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NJ md02133) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ md02133) | |
| Enumeration Date | 2006-03-20 |
| Last Update Date | 2019-05-21 |