| NPI | 1164196267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MARCHESE Credentialing Manager 214-205-4995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2024-06-04 |