Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | KK537351 | CA |
NPI | 1134752942 |
---|---|
Provider Name | Elizabeth Olajide |
First Address | Lancaster, CA 93536-5229 |
Second Address | Lancaster, CA 93534-6036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2020 |
Last Update Date | 20/02/2020 |