| NPI | 1184050650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO M BENNETT President 703-361-3132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Additional Taxonomies | 213EP1101X Podiatrist Primary Podiatric Medicine |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2013-09-17 |