| NPI | 1427369164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: TN DPM741) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT pending) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TN DPM741) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: KY 00438) | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2024-01-11 |