| NPI | 1205242435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: WV 10451) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA EL6714) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2018-03-17 |