| NPI | 1548275969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: AZ 0644) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: AZ 0644) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2011-10-12 |