| NPI | 1285952937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X (Licence: OH 36.003657) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: OH 36.003657) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36003657) | |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2024-11-14 |