| 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 |