NPI | 1083866206 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY N006230) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N006230) |
Enumeration Date | 2008-10-21 |
Last Update Date | 2010-12-06 |