| NPI | 1710018007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00230600) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N0057841) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ md02306) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2024-07-25 |