NPI | 1780171637 |
---|---|
Former Name | STEPHANIE LEE PETROFSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: KY 281873) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: OH 36004004) |
213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IN 07001411A) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-17 |
Last Update Date | 2023-05-01 |