| NPI | 1427158898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: RI DPM00277) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: RI DPM00277) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2012-01-24 |