| NPI | 1649895848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: CT 001177) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 5951001387) |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2024-09-17 |