| NPI | 1205079324 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 213E00000X Podiatrist (Licence: FL PO3436) | 
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO3436) | 
| Enumeration Date | 2009-04-20 | 
| Last Update Date | 2024-05-28 |