| NPI | 1285253534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY 007294) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT 13204318-0501) |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2024-08-28 |