| NPI | 1215939392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: SD 180) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IA 00781) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2014-01-24 |