| NPI | 1588980114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY GOSS Provider 215-483-2006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC004111L) |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2013-12-31 |