| NPI | 1245559277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY N006547-1) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0116022359) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006437) | |
| Enumeration Date | 2010-06-01 |
| Last Update Date | 2023-04-18 |