| NPI | 1124840632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE TUNG President 952-465-2830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Additional Taxonomies | 213E00000X Podiatrist |
| 213ES0000X Podiatrist, Sports Medicine | |
| Enumeration Date | 2024-10-26 |
| Last Update Date | 2025-01-27 |