Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | SC006537 | PA |
NPI | 1003222555 |
---|---|
Provider Name | Regina Snow |
First Address | Drexel Hill, PA 19026-3805 |
Second Address | Philadelphia, PA 19128-1737 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2014 |
Last Update Date | 02/08/2017 |