Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | SC007213 | PA |
NPI | 1023681269 |
---|---|
Provider Name | Dr. Victoria M. Adeniran |
First Address | Bryn Mawr, PA 19010 |
Second Address | Philadelphia, PA 19128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2021 |
Last Update Date | 24/07/2021 |