NPI | 1932548146 |
---|---|
Former Name | MEGAN JO SANDORA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL po4130) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006495) |
Enumeration Date | 2013-06-20 |
Last Update Date | 2020-02-24 |