| NPI | 1093042632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA L KING Member/Owner 505-988-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2015-06-14 |