| NPI | 1548359318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: PA SC004724L) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: DE E1-0000148) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2022-07-18 |