| NPI | 1942455910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK HAAS Owner 505-247-4164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM 308) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM 325) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: NM 136) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM nm181) | |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2012-05-17 |