| NPI | 1558360875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MI 5901002628) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: OH 36003381) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2017-02-28 |