| NPI | 1578674800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: VA 0103301097) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: AZ 606) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-01-24 |