| NPI | 1396164117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: PA SC006436) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: DE E1-0000220) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2016-04-22 |