| NPI | 1275972259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MN 978) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 590100286) |
| Enumeration Date | 2013-06-23 |
| Last Update Date | 2018-03-17 |