| NPI | 1821181082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY N005039-1) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00273200) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: NY N005039-1) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-04-07 |