| NPI | 1295739019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NC 203) |
| Additional Taxonomies | 213ES0131X (Licence: NC 203) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NC 203) | |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2016-06-01 |