| NPI | 1356865489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: GA POD001466) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: IL 135.000984) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2022-02-09 |