| NPI | 1568959278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: TN 919) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: TN 919) |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: TN 919) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2023-12-07 |