| NPI | 1063736569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MD 01571) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: DE E1-0000231) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: DC PO1000122) | |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2023-02-28 |