| NPI | 1679199962 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 213E00000X Podiatrist (Licence: FL PO4369)  | 
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: FL PO4369)  | 
| 213ES0000X Podiatrist, Sports Medicine (Licence: FL PO4369)  | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: FL PO4369)  | |
| 213ES0131X  (Licence: FL PO4369)  | |
| Enumeration Date | 2020-06-22 | 
| Last Update Date | 2025-03-10 |