| NPI | 1396146957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NM POD424) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 3014) |
| Enumeration Date | 2014-09-12 |
| Last Update Date | 2021-09-22 |