| NPI | 1225034028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IN 07000846) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07000846) |
| 213ES0131X (Licence: IN 07000846) | |
| 213E00000X Podiatrist (Licence: IN 07000846) | |
| 213EP0504X Podiatrist, Public Medicine (Licence: IN 07000846) | |
| 213ER0200X Podiatrist, Radiology (Licence: IN 07000846) | |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2008-09-19 |