| NPI | 1467560532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: NY N004973) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: NY N004973) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ MD2186) | |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2021-04-15 |