| NPI | 1770356040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ISAAC JOHNSON Doctor Of Podiatric Medicine 716-495-2522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2023-12-18 |