NPI | 1497819247 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N004109) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 309257) |
Enumeration Date | 2006-12-19 |
Last Update Date | 2011-02-24 |