| NPI | 1316280282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X Podiatrist Foot Surgery (Licence: NH 0385) |
| Additional Taxonomies | 213ES0131X Podiatrist Foot Surgery (Licence: NY N006747) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2022-11-23 |