| NPI | 1558193441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAZEL ESCULLAR LLOCE Practice Manager 480-360-3853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-10-09 |