| NPI | 1053418020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: FL PO3025) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: WI 943-025) |
| 213E00000X Podiatrist (Licence: TX 1921) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2015-01-13 |