| NPI | 1376053694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MA 2465) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC006247) |
| Enumeration Date | 2017-10-02 |
| Last Update Date | 2022-02-24 |