| NPI | 1508866765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: GA 000729) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: GA 000729) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2013-08-27 |