| NPI | 1710988258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X (Licence: PA SC002712L) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC002712-L) |
| 213EP0504X Podiatrist, Public Medicine (Licence: PA SC002712-l) | |
| 213ER0200X Podiatrist, Radiology (Licence: PA SC002712-L) | |
| 213ES0000X Podiatrist, Sports Medicine (Licence: PA SC002712-L) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: PA SC002712-l) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2013-08-12 |