| NPI | 1053684399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: GA POD001205) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E4984) |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2021-12-15 |