| NPI | 1619309135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NC 632) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC006469) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2022-05-03 |