| NPI | 1316387186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00370500) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006501) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36.003718) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2022-12-09 |