| NPI | 1336523166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: GA POD001276) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC006530) |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2017-11-10 |