| NPI | 1063156073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER AYODELE OTIKO President 818-836-2475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2022-04-25 |