| NPI | 1285823401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: VA 0103301022) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC005847) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2019-11-05 |