| NPI | 1528633096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MA PDF2560) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: OH 59.000894) |
| 213ES0131X Podiatrist, Foot Surgery (Licence: MA PDF2560) | |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2024-09-05 |