| NPI | 1649566092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: NC 739) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CT 000910) |
| 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: NC 27672) | |
| 213EP1101X Podiatrist Primary Podiatric Medicine (Licence: NC 739) | |
| 213ES0131X Podiatrist Foot Surgery (Licence: NC 739) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2025-05-08 |