| NPI | 1609180207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: DC 404) |
| Additional Taxonomies | 213ES0131X Podiatrist, Foot Surgery (Licence: DC PO404) |
| Enumeration Date | 2010-08-06 |
| Last Update Date | 2015-02-25 |