| NPI | 1265918122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0103301314) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC006919) |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2021-06-29 |