| NPI | 1841341021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TN 912) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TN 912) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2025-02-19 |