| NPI | 1073505608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: KY 00304) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: OH 36003377) |
| Enumeration Date | 2005-08-19 |
| Last Update Date | 2016-03-22 |