NPI | 1679033062 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: TX 692130) |
Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: NV 2086) |
Enumeration Date | 2019-03-21 |
Last Update Date | 2024-07-15 |