| NPI | 1073928164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016005711) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 135000849) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 2017010428) | |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2023-03-16 |