| NPI | 1558590471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MI 5901002485) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E4939) |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4939) | |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2013-07-03 |