| NPI | 1700106424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNN D MALAKA Owner 703-232-5776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0103301025) |
| Enumeration Date | 2010-06-04 |
| Last Update Date | 2018-01-11 |