| NPI | 1710955752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: IL 016003257) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016-003257) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2012-04-24 |