| NPI | 1932372638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00297100) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3726) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY 006268) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WA PO60255094) | |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2022-06-17 |