| NPI | 1427331347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016005508) |
| Additional Taxonomies | 213ES0131X (Licence: IL 016005508) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2026-07-23 |