NPI | 1013254135 |
---|---|
Former Name | DESIREE DEE DIEBOLD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX tx3005) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: TX tx3005) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NC TR-128) | |
Enumeration Date | 2013-01-09 |
Last Update Date | 2024-09-18 |