| NPI | 1124339015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 2114) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: PA SC006234) |
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: FL PO 3596) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006234) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO 3596) | |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2019-04-15 |