| NPI | 1902664394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAKR ASIF Owner 551-580-2907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery |
| Additional Taxonomies | 213EP1101X Podiatrist Primary Podiatric Medicine |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2025-08-21 |