| NPI | 1043219215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: MO 2008030512) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IL 016004789) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2023-12-21 |