| NPI | 1477527562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NC 750) |
| Additional Taxonomies | 213ES0131X (Licence: NC 750) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NC 750) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2022-08-09 |