| NPI | 1134400492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MI 5901002396) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: GU POD-8) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2019-07-14 |