| NPI | 1508338054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH LOIS MINA Owner/Doctor 707-241-4116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2019-08-27 |