| NPI | 1922081413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: FL PO1951) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: FL PO1951) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2008-06-06 |