| NPI | 1205356235 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CO POD.0000862)  | 
| Additional Taxonomies | 213E00000X Podiatrist (Licence: WI 18162-875)  | 
| Enumeration Date | 2017-06-21 | 
| Last Update Date | 2025-06-27 |