| NPI | 1578637633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO M. BENNETT President 703-361-3132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: VA 0103001009) |
| Additional Taxonomies | 213ES0131X Podiatrist Foot Surgery (Licence: VA 0103000268) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2012-12-18 |