| NPI | 1275829954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016005559) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016005559) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: IL 135000730) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2020-07-01 |