| NPI | 1093712184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: DC PO423) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: MD 00926) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2010-12-03 |