| NPI | 1689626194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016-003540) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IA 00438) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E3591) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NE 272) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2008-04-22 |