| NPI | 1629036728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: DE EL-0000075) |
| Additional Taxonomies | 213ES0000X Podiatrist Sports Medicine (Licence: DE EL-0000075) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2007-12-05 |