| NPI | 1124197124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: TX 1915) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: NV 0803) |
| 213E00000X Podiatrist (Licence: NY 006171) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2023-07-01 |