| NPI | 1154323731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07001006A) |
| Additional Taxonomies | 213ES0131X (Licence: IN 07001006) |
| 213ES0000X Podiatrist, Sports Medicine (Licence: IN 07001006) | |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2026-03-19 |