| NPI | 1063410470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: NY 004733) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY n004733) |
| Enumeration Date | 2005-07-09 |
| Last Update Date | 2011-10-13 |