| NPI | 1184763500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IA 00813) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 5901002215) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2008-10-29 |