| NPI | 1225094642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X (Licence: PA SC006975) |
| Additional Taxonomies | 213ES0131X (Licence: NY ny005929) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY ny005929) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2019-06-13 |