| NPI | 1366983645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MN 1101) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: WA PO61174009) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2022-08-02 |