NPI | 1861559569 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00293000) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA sc005761) |
Enumeration Date | 2007-01-02 |
Last Update Date | 2011-09-19 |