| NPI | 1194025213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: UT 5765339-0501) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: UT 5765339-4901) |
| 213E00000X Podiatrist (Licence: CA e4105) | |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-10-22 |