NPI | 1437104635 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N004234) |
Additional Taxonomies | 213ES0000X Podiatrist, Sports Medicine (Licence: NY N004234) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY N004234) | |
Enumeration Date | 2006-05-24 |
Last Update Date | 2019-09-12 |