| NPI | 1316150949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AR 240) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IN 99026414) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2011-03-22 |