| NPI | 1295258366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X (Licence: CA E5888) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: WA PO61035595) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY P07118) | |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2022-08-24 |