| NPI | 1164454609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: SC 718) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CA E4566) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2024-10-03 |