NPI | 1578577979 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N0037141) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: NJ 25MD00298200) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2011-09-02 |