| NPI | 1063617645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: DC PO551) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: MD 01239) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2020-08-10 |