| NPI | 1205146164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36003568) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 59.000268) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3618) | |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2019-02-21 |