| NPI | 1548231822 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY 004512) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N004512) |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2021-12-07 |