NPI | 1861424624 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016004743) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016004743) |
213EP0504X Podiatrist, Public Medicine (Licence: IL 016004743) | |
213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IL 016004743) | |
213ER0200X Podiatrist, Radiology (Licence: IL 016004743) | |
213ES0000X Podiatrist, Sports Medicine (Licence: IL 016004743) | |
Enumeration Date | 2006-07-06 |
Last Update Date | 2020-05-04 |