| NPI | 1457327173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IL 016-003964) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IN 07000623A) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2014-05-12 |