| NPI | 1609813252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: TX 1799) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: VA 0103300730) |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2018-07-04 |