| NPI | 1073832382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC005987) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC005987) |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2024-08-26 |