NPI | 1215935358 |
---|---|
Former Name | BARBARA JEAN BRAINERD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: OK 176) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: OK 176) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 000582) | |
Enumeration Date | 2005-07-12 |
Last Update Date | 2021-12-23 |