| NPI | 1023538568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: AR 290) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: LA 306037) |
| Enumeration Date | 2017-06-26 |
| Last Update Date | 2020-09-29 |