| NPI | 1295149391 |
|---|---|
| Former Name | MARISSA MCNELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: WI 1099-25) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IN 41000316A) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2021-07-23 |