| NPI | 1710241625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IN 07001201A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA SC006398) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2021-12-22 |