| NPI | 1437238011 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N004355) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: FL PO2818) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2025-02-25 |