| NPI | 1356748313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA M FAUVER Credentialing Manager 440-357-8418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: OH 36.003681) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2025-02-24 |