| NPI | 1518950294 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X (Licence: TX 1467) |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: TX 1467) |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2019-08-23 |