| NPI | 1386642759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: TX 0822) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 0822) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2020-03-23 |