| NPI | 1902014301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 41000207-A) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IN 07001065A) |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2010-03-22 |