| NPI | 1003617853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GIFFORD Authorized Official 928-955-0777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2025-03-19 |
| Last Update Date | 2025-07-08 |