Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1083154058 |
---|---|
Provider Name | Amira Mouad |
First Address | Exton, PA 19341-0573 |
Second Address | Asheville, NC 28803-8586 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2017 |
Last Update Date | 24/02/2017 |