| NPI | 1215454046 |
|---|---|
| Former Name | SOPHIA LEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: AZ POD-000958) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2021-01-08 |