NPI | 1619359510 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 213E00000X Podiatrist (Licence: AZ POD-001093) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MN 1045) |
213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: IL 135.000879) | |
Enumeration Date | 2015-06-26 |
Last Update Date | 2024-07-16 |