| NPI | 1437268224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: DC PO1000053) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N005820) |
| 213E00000X Podiatrist (Licence: VA 103300954) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2024-07-23 |