| NPI | 1497098859 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery (Licence: FL ME153203) | 
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT204402) | 
| Enumeration Date | 2013-04-03 | 
| Last Update Date | 2022-01-05 |