| NPI | 1336156090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MO 795) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: KS 12000295) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2009-11-19 |