| NPI | 1407018252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: VA 0103301040) |
| Additional Taxonomies | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: VA 0103301040) |
| 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: PA SC006055) | |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: PA SC006055) | |
| Enumeration Date | 2008-07-01 |
| Last Update Date | 2011-08-19 |