| NPI | 1568925907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: VA 0103301373) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH TRAINING) |
| Enumeration Date | 2019-04-11 |
| Last Update Date | 2024-04-03 |