| NPI | 1609042779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: VA 0103301222) |
| Additional Taxonomies | 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: VA 0103301222) |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: WA PO60013358) | |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2025-01-23 |