| NPI | 1134248784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5901002250) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 5901002250) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-01-17 |