| NPI | 1366751109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: LA DPM.200055) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA EL1783) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2012-12-06 |