| NPI | 1477746543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY 65 006234) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 006234) |
| 213E00000X Podiatrist (Licence: NY 006234) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2025-08-07 |