NPI | 1962449751 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: NY N006155) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY N006155) |
Enumeration Date | 2006-06-01 |
Last Update Date | 2025-08-21 |