| NPI | 1043907942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 135001209) |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: IL 135001209) |
| Enumeration Date | 2023-04-20 |
| Last Update Date | 2025-11-06 |