| NPI | 1407875743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: KY 243989) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: KY 00267) |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: KY 00267) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2018-11-12 |