| NPI | 1518341254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CT 001110) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: RI 00) |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IA 092604) | |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2021-11-16 |