| NPI | 1114587490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 2021035408) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 561) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2021-09-13 |