| NPI | 1245111491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE SELMAN Admin 469-441-4484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2025-09-11 |
| Last Update Date | 2025-11-04 |