NPI | 1528061819 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: OH 36003373) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36003373) |
Enumeration Date | 2005-05-31 |
Last Update Date | 2023-05-23 |