| NPI | 1922704394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAWSAR IBRAHIM Podiatrist 917-409-6505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2023-02-06 |
| Last Update Date | 2024-04-11 |