| NPI | 1295191112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016.005775) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 135.000901) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 2018037270) | |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2023-11-27 |