| NPI | 1760462089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 070000768A) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IN 05001328A) |
| 213E00000X Podiatrist (Licence: IN 070000768A) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2021-11-23 |