| NPI | 1093709750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 07001040A) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 599) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07001040A) | |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2022-04-06 |