| NPI | 1255339511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MD 01261) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: WV 00337) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2011-11-08 |