| NPI | 1013044411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X (Licence: PA sc005925) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4878) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2010-06-08 |