| NPI | 1154566396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MN 830) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: WI 969-025) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2024-05-20 |