| NPI | 1114528726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEKSANDER VALENTINOVICH LAVRENOV President 917-687-7528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2020-11-02 |