| NPI | 1407829328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: VA 0103300920) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: VA 0103300920) |
| 213ER0200X Podiatrist, Radiology (Licence: VA 0103300920) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2017-08-22 |