| NPI | 1114160389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AR 242) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MS 80197) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 2007024292) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TN 695) | |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2020-07-22 |