NPI | 1134569734 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36.003756) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: OH 36003756) |
Enumeration Date | 2013-06-27 |
Last Update Date | 2022-12-06 |