| NPI | 1710972716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC-004807) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: PA SC-004807) |
| 213ER0200X Podiatrist, Radiology (Licence: PA SC-004807) | |
| 213ES0131X Podiatrist, Foot Surgery (Licence: PA SC-004807) | |
| 213E00000X Podiatrist (Licence: PA SC004807) | |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2008-04-15 |