| NPI | 1396780128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MD 01384) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: DC PO1000049) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: VA 0103300869) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2007-07-08 |