| NPI | 1487819173 |
|---|---|
| Former Name | ALIYA FAGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: GA POD001184) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006065) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MD 01490) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA sc006065) | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2020-04-18 |