| NPI | 1063677284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MO 2010022626) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: KS 12-00389) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2021-08-20 |