Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | SC006685 | PA |
NPI | 1083097794 |
---|---|
Provider Name | Amy Michelle Kruger |
First Address | Richmond, VA 23226-2443 |
Second Address | Richmond, VA 23226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2015 |
Last Update Date | 16/07/2018 |