NPI | 1467451583 |
---|---|
Former Name | AVA J. THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: CO 721) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: VI 1188) |
213E00000X Podiatrist (Licence: PA SC004676R) | |
Enumeration Date | 2005-07-20 |
Last Update Date | 2021-02-24 |