| NPI | 1225463284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X (Licence: PA SC006523) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006523) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2023-10-03 |