| NPI | 1295017150 |
|---|---|
| Former Name | ANGELA M BONNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: VA 0103301190) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5901002380) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2024-12-18 |