NPI | 1134196801 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: NY N002832) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N002832) |
Enumeration Date | 2006-03-02 |
Last Update Date | 2023-03-07 |