| NPI | 1427116300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X (Licence: ME POD229) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: PA SC003477L) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2019-09-23 |