| NPI | 1205214053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MI 5901400488) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E5492) |
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: CA E5492) | |
| 213ES0000X Podiatrist, Sports Medicine (Licence: CA E5492) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: UT 9832253-0501) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E5492) | |
| 213ES0131X Podiatrist, Foot Surgery (Licence: CA E5492) | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2023-08-07 |