| NPI | 1629450655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MD 01727) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC006675) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NJ 25MD00344700) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GA POD001422) | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2021-09-17 |