Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | ||
N | 222Z00000X | Podiatrist | ||
Y | 224P00000X | Prosthetist |
NPI | 1376188920 |
---|---|
Provider Name | Dianna Le |
First Address | Hagatna, GU 96932-8473 |
Second Address | Honolulu, HI 96826-1027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2019 |
Last Update Date | 12/11/2020 |