| NPI | 1295046555 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0000X Podiatrist Sports Medicine (Licence: WA PO60362085) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MA 1257) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2013-07-18 |