| NPI | 1619264041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 016.005524) |
| Additional Taxonomies | 213ES0131X (Licence: IL 016005524) |
| 213E00000X Podiatrist (Licence: IL 135000752) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2019-08-12 |