| NPI | 1457796617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 2189) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: TX 2189) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2018-09-10 |