| NPI | 1578900106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NC 637) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: WA PO60626134) |
| 213E00000X Podiatrist (Licence: OH 36.003748) | |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2024-03-06 |