NPI | 1194347823 |
---|---|
Former Name | ASANTE PACE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: TX 692171) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 692171) |
Enumeration Date | 2020-05-15 |
Last Update Date | 2024-10-07 |