| NPI | 1538767850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN EDWARD Credentialing Specialist 646-639-5291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2021-01-15 |