| NPI | 1184249153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: TX 692094) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TX t15-2020) |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2024-05-08 |