| NPI | 1063023000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANCIS LANCE CONDA Credentialing Manager 410-927-3510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |