| NPI | 1326427584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: WA PO60977510) |
| Additional Taxonomies | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: WA PO60977510) |
| 213E00000X Podiatrist (Licence: WA PO60977510) | |
| 213ER0200X Podiatrist Radiology (Licence: WA PO60977510) | |
| 213ES0000X Podiatrist Sports Medicine (Licence: WA PO60977510) | |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2020-05-18 |