| NPI | 1851536023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07001105A) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX T13-2008) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2022-10-20 |