| NPI | 1578729026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OH 36.003525) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: OH 36.003525) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2014-10-21 |