| NPI | 1932595345 |
|---|---|
| Former Name | CARMEN JOANN MALDONADO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: LA 302526) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2018-08-09 |