| NPI | 1508495748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist Foot Surgery (Licence: MN PD1189) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: PA SC0007325) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2024-08-09 |