| NPI | 1033352745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS D NELSON Provider 661-322-2895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E2286) |
| Enumeration Date | 2009-04-10 |
| Last Update Date | 2009-04-10 |