| NPI | 1922150010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IL 016004682) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: FL PO4082) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2023-03-24 |