| NPI | 1205866548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: TX 1773) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: TX 1773) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2008-05-28 |