| NPI | 1396324711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: NY 007413) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY 007413) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-04 |
| Last Update Date | 2024-07-16 |