| NPI | 1427467703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016005804) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MN 966) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY R93661) | |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2018-11-29 |