| NPI | 1114956588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: GA POD 1075) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: FL PO 3247) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2008-06-17 |