| NPI | 1629369996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO DAVIDSON Owner 732-709-3405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00307600) |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-04-21 |