| NPI | 1275196883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: VA 0103301363) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: OH 59.000793) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2023-01-27 |