| NPI | 1427051291 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07000970A) | 
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IN 07000970A) | 
| Enumeration Date | 2005-05-24 | 
| Last Update Date | 2023-07-08 |