| NPI | 1639664766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: SC 721) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: RI LPR00194) |
| 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: RI LPR00194) | |
| Enumeration Date | 2018-07-01 |
| Last Update Date | 2024-02-15 |