| NPI | 1144280892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: AZ 0701) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MA 2213) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: MA 2213) | |
| Enumeration Date | 2006-03-26 |
| Last Update Date | 2015-09-09 |