| NPI | 1811154339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: NY N006272-1) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: NY 006272) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2019-12-05 |