| NPI | 1396185575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY 006572) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N006572) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2023-01-27 |