| NPI | 1245712678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016006010) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AZ POD-001042) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-09-01 |
| Last Update Date | 2024-02-20 |