| NPI | 1679096176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MI 5901400524) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: IA 092742) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2024-02-26 |