| NPI | 1114118361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MO 2009033094) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: KS 12-00375) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2012-10-03 |