| NPI | 1104095637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IKE B GORMAN Owner 520-722-5115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: AZ 301) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2011-05-17 |