| NPI | 1285634261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: TX 0835) |
| Additional Taxonomies | 213ES0131X Podiatrist Foot Surgery (Licence: TX 0835) |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2018-08-16 |