| NPI | 1053794859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016005897) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5901002587) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2024-01-22 |