NPI | 1063425361 |
---|---|
Former Name | STACEY L BIELINSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016005295) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016005295) |
Enumeration Date | 2006-08-15 |
Last Update Date | 2022-06-21 |