| NPI | 1508180712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA R SELLERS-HANNIBAL Owner 410-581-8331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: MD 01173) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MD 01173) |
| 213E00000X Podiatrist (Licence: DC PO543) | |
| 213ES0131X Podiatrist, Foot Surgery (Licence: DC PO543) | |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2010-03-17 |