| NPI | 1770214116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD305067) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 4100048A) |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2025-09-15 |