| NPI | 1003296369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ESKAROUS Secretary 6082-132-8363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C55850) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E4996) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2015-06-09 |