| NPI | 1477740975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY AJOLO BULAHAO Owner 210-599-3008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: TX 1606) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2008-03-20 |