NPI | 1245624337 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WV 10465) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO4007) |
Enumeration Date | 2015-03-26 |
Last Update Date | 2022-04-18 |