| NPI | 1023450145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IA 085216) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IL 135.000811) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2019-02-13 |