Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 631 | SC |
NPI | 1245556992 |
---|---|
Provider Name | Sara Borkosky |
First Address | Mauldin, SC 29662-2626 |
Second Address | Mauldin, SC 29662-2626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2010 |
Last Update Date | 28/07/2014 |