Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | VA |
NPI | 1073277901 |
---|---|
Provider Name | Monica Sonpon |
First Address | Stafford, VA 22555-0241 |
Second Address | Stafford, VA 22554-7284 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2021 |
Last Update Date | 27/10/2021 |