| NPI | 1447392972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: IL 016.004243) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: MO 2004030548) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2022-06-29 |