| NPI | 1598148116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MI 5901002596) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 5901002596) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2025-01-16 |