| NPI | 1144350125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: IN 07000879A) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: MA 2094) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2013-02-12 |