| NPI | 1720427040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IL 016005803) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IN 07001225A) |
| 213E00000X Podiatrist (Licence: IN 07001225A) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2021-04-12 |