| NPI | 1497126981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: DE E1-0000246) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: DE E1-0000246) |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2018-08-02 |