| NPI | 1427082726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 07001039A) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MS 80139) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2015-02-17 |