| NPI | 1891227195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IL 016.005909) |
| Additional Taxonomies | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: IL 016.005909) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2023-03-13 |