| NPI | 1811227762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NDEM NDEM Owner 706-653-5282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD000872) |
| Enumeration Date | 2009-12-28 |
| Last Update Date | 2011-05-19 |