| NPI | 1932203577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NY 004993) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NY N004993-1) |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2008-02-05 |