| NPI | 1144211491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X (Licence: IN 07000778A) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IN 07000778A) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07000778A) | |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2025-01-08 |