| NPI | 1477743698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAITRAYA D THAKER President 770-349-9861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist Foot Surgery (Licence: NY N004044) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2012-12-26 |