| NPI | 1447440292 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NJ 25MD00293500) |
| Additional Taxonomies | 213ES0000X Podiatrist Sports Medicine (Licence: NJ 25MD00293500) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2014-05-20 |