| NPI | 1568579050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: NY N004950) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N0049501) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2019-06-27 |