| NPI | 1285651018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: NY 002240) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N0060261) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-07-25 |