NPI | 1043693666 |
---|---|
Former Name | STEFANIE ANN ELITHARP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO 0000817) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5901002600) |
Enumeration Date | 2015-07-01 |
Last Update Date | 2018-05-24 |