| NPI | 1578137949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: CA E6063) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2024-08-05 |