| NPI | 1083957088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: OR DP220790) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IL 016-005738) |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2026-03-11 |