| NPI | 1558855155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5951001077) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 5901400467) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2024-04-11 |