Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter |
NPI | 1548388531 |
---|---|
Provider Name | Temitayo Thaise Akinshilo |
First Address | Los Angeles, CA 90034-3970 |
Second Address | Los Angeles, CA 90034-3970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 08/07/2007 |