| NPI | 1083811541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: DE E1-0000198) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006011) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MD P00550) | |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2016-05-27 |