| NPI | 1023734365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE ELIZABETH VARGHESE Owner 267-524-9436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2022-10-18 |
| Last Update Date | 2023-11-15 |