| NPI | 1063606135 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01034522A) | 
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: IN 01034522) | 
| Enumeration Date | 2007-08-31 | 
| Last Update Date | 2011-11-16 |