| NPI | 1336796143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IL 016.006003) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 135.001068) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2023-03-28 |