| NPI | 1720477672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGIE LASORELLA Credentialing Supervisor 513-829-9333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2024-09-04 |