NPI | 1033415799 |
---|---|
Entity Type | Organization |
Authorized Contact | KHAM VAY UNG President/Owner 712-255-0502 |
Organization Subpart ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IA 00505) |
Enumeration Date | 2011-01-28 |
Last Update Date | 2016-06-14 |