| NPI | 1659504801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: DE E1-0000192) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: DE E1-0000192) |
| 213E00000X Podiatrist (Licence: PA SC0005926) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC0005926) | |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2023-11-28 |