| NPI | 1851393870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: NY 005831) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: NY N005831-3) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2008-02-05 |