NPI | 1033279138 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00157700) |
Additional Taxonomies | 213ES0000X Podiatrist, Sports Medicine (Licence: NJ 25MD00157700) |
Enumeration Date | 2006-12-11 |
Last Update Date | 2009-05-19 |