| NPI | 1699724427 |
|---|---|
| Professional Name | MIKE D THAKER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA 000650) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY N004044-1) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2023-03-21 |