| NPI | 1629419353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MI 5901400368) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MD 01601) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2022-08-04 |