| NPI | 1578629770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X (Licence: FL po 3281) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: FL po 3281) |
| 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: FL po 3281) | |
| 213ER0200X Podiatrist, Radiology (Licence: FL po 3281) | |
| 213ES0000X Podiatrist, Sports Medicine (Licence: FL po 3281) | |
| 213ES0000X Podiatrist, Sports Medicine (Licence: NV 2002) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL po 3281) | |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2025-06-09 |