NPI | 1700126885 |
---|---|
Former Name | ANNABELLE LEE SANTOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016.005771) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO 3652) |
Enumeration Date | 2013-02-26 |
Last Update Date | 2018-07-19 |