| NPI | 1992439657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016-006099) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IL 016-006099) |
| Enumeration Date | 2022-07-10 |
| Last Update Date | 2025-06-10 |