| NPI | 1538504345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIYA BOYCE Regional Credentialing Specialist 704-897-2261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WV 00363) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2023-12-07 |