| NPI | 1538261722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36002671) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: OH 36002671) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2011-12-06 |