| NPI | 1518697275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247200000X (Licence: OR COS-CI-10177944) |
| Additional Taxonomies | 261QP1100X Clinic/Center, Podiatric (Licence: OR COS-CI-10177944) |
| 246Z00000X Specialist/Technologist, Other (Licence: OR COS-CI-10177944) | |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2022-06-22 |