| NPI | 1730576364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: GA pod001451) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC006957) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2021-10-14 |