| NPI | 1154702827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: GA POD001377) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TN 838) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX T55-2015) | |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2019-01-07 |