| NPI | 1528050994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: WA PO00000715) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: ID p218) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2015-11-10 |