| NPI | 1558154625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YASSER SUFYAN President 313-333-0564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric |
| Enumeration Date | 2025-05-22 |
| Last Update Date | 2025-09-08 |