| NPI | 1063665636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist, Foot Surgery (Licence: SC 610) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3416) | |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2021-09-01 |