| NPI | 1033406848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: FL PO3725) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: FL RESIDENT) |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: PA SC006532) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2015-06-02 |