| NPI | 1356623771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EKA DAVITACHVILI Incorporator/Director/Dpm 917-399-0361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N006252) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2011-09-12 |