| NPI | 1649720301 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILA BRAGER Credentialing Coordinator 260-432-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2016-11-17 |