Individual
ITOHAN AIKHIONBARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1015 WALNUT ST, PHILADELPHIA, PA 19107-5005
(215) 955-8612
Mailing address
1015 WALNUT ST STE 620, PHILADELPHIA, PA 19107-5005
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MT228867
PA
Other
Enumeration date
06/01/2023
Last updated
06/03/2023
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