| NPI | 1306322201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CO 879) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IA 092404) |
| 213EP0504X Podiatrist, Public Medicine (Licence: IA 092404) | |
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IA 092404) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IA 092404) | |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2021-07-23 |