| NPI | 1164657680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LOHREY Credentialing Specialist 317-336-2106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IN 07000551A) |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2009-05-28 |