| NPI | 1689014425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: PA SC006479) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: PA SC006479) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2019-11-13 |