NPI | 1598022790 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: NY 65P80326) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: NY 65P80326) |
Enumeration Date | 2012-04-12 |
Last Update Date | 2012-04-12 |