| NPI | 1043211964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: FL P02402) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: FL PO2402) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2013-08-13 |