NPI | 1164012720 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 590140046) |
Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: MI 590140046) |
213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NY P101504) | |
Enumeration Date | 2021-01-19 |
Last Update Date | 2023-08-24 |