| NPI | 1578563458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: KY 00179) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: KY 00179) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2012-10-03 |