NPI | 1063419869 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: ME POD1047) |
Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: ME POD1047) |
Enumeration Date | 2005-07-07 |
Last Update Date | 2015-07-31 |