| NPI | 1346694932 |
|---|---|
| Former Name | TATYANA ASTAFIEV |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: OH 36.003926) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2019-07-09 |