NPI | 1003235250 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016.005765) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: IL 016005765) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 41000307A) | |
Enumeration Date | 2014-04-15 |
Last Update Date | 2024-07-10 |