| NPI | 1508956707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: IL 016003520) |
| Additional Taxonomies | 213ES0000X Podiatrist, Sports Medicine (Licence: IL 016003520) |
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: IL 016003520) | |
| 213ER0200X Podiatrist, Radiology (Licence: IL 016003520) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016003520) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2022-10-03 |