| NPI | 1659677318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHAM VAY UNG President/Owner 712-255-0502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IA 00505) |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2016-06-14 |