| NPI | 1104092113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: AL 328) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CT 000853) |
| 213E00000X Podiatrist (Licence: FL PO3855) | |
| 213E00000X Podiatrist (Licence: IL 016005364) | |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2021-10-15 |