| NPI | 1629099478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0131X Podiatrist Foot Surgery (Licence: FL PO 0002500) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: FL PO2500) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2017-04-28 |