| NPI | 1407012487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4928) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016005424) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC005936) | |
| Enumeration Date | 2008-07-30 |
| Last Update Date | 2020-11-12 |