| NPI | 1417518374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CA E5820) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 5951001239) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2022-06-27 |