| NPI | 1710306501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEKSANDER VALENTINOVICH LAVRENOV President 917-687-7528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E 5019) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2014-06-04 |