| NPI | 1356349575 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MD 01425)  | 
| Additional Taxonomies | 213E00000X Podiatrist (Licence: DC PO1000045)  | 
| Enumeration Date | 2005-07-12 | 
| Last Update Date | 2025-05-12 |