| NPI | 1124430806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MI 5901002584) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MI 5315080074) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2022-06-15 |