| NPI | 1558703298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016005811) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: MI 5901002505) |
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IL 016005811) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5901002505) | |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2023-01-20 |