| NPI | 1295780153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: IL 016-005209) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 1957) |
| 213E00000X Podiatrist (Licence: MO 2011018233) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2019-01-22 |