NPI | 1427154988 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ 25MD00134100) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC002395L) |
Enumeration Date | 2006-09-15 |
Last Update Date | 2009-08-18 |