| NPI | 1710234315 |
|---|---|
| Former Name | ANGELA EDWARDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NM 383) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 2160) |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2019-09-23 |